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ISSN: 1734-4948
Advances in Rehabilitation
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abstract:
Original article

Bilateral transcutaneous tibial nerve stimulation: a promising treatment for women with postpartum constipation: A randomized controlled trial

Afaf Mohamed Mahmoud Botla
1
,
Marwa Shafiek Mustafa Saleh
2
,
Walaa Salah Mohamed Ahmed
3
,
Saged Mohammed Elmazly
4
,
Donia Mohamed Moustafa Ahmed Elmasry
5
,
Manal Ahmed El-Shafei Mohamed
1

  1. Department of Physical Therapy for Women’s Health, Faculty of Physical Therapy, Cairo University, Giza, Egypt
  2. Department of Basic Sciences, Faculty of Physical Therapy, Cairo University, Giza, Egypt Department of Physical Therapy, Faculty of Applied Medical Sciences, Al-Zaytoonah University of Jordan, Amman, Jordan
  3. Department of Physical Therapy, Quallin Specialized Hospital, Ministry of Health, Kafr El Sheikh, Egypt
  4. Department of Obstetrics and Gynecology, Faculty of Medicine, Al Azhar University, Cairo, Egypt
  5. Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
Advances in Rehabilitation
DOI: https://doi.org/10.5114/areh.2024.144633
Online publish date: 2024/10/31
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Introduction
Postpartum constipation is a frequent occurrence following a cesarean section delivery. In addition to the widely documented side effects, medications such as laxatives effectively address constipation, with their effects ceasing upon discontinuation of the medication. This study sought to examine whether bilateral transcutaneous tibial nerve stimulation (TTNS) could be more beneficial in treating postpartum constipation.

Material and methods
Fifty-six women, with an age between 20 and 35 years and Body Mass Index (BMI) ranging from 25 to 33 kg/m2, who complained of constipation after giving birth, were randomly allocated into two equal groups. TTNS group: women received bilateral TTNS, diaphragmatic breathing, abdominal muscle training, and behavioral therapy advice. Control group: women were treated with similar therapy as the TTNS group, without the TTNS program. Each woman in each group was assessed before and after 12 sessions of the treatment through the Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL), the Patient Assessment of Constipation Symptom Questionnaire (PAC-SYM), and the Bristol Stool Form Scale (BSFS).

Results
Our results showed that all outcome variables in both groups revealed a statistically significant improvement after therapy compared to before (p 0.05). In contrast, PAC-SYM and PAC-QOL scores revealed a statistically significant variation (p < 0.05) across both groups, favoring the TTNS group.

Conclusions
When treating constipation in postpartum women, adding bilateral TTNS to traditional physiotherapy treatment might be better than using traditional therapy alone.

keywords:

Postpartum period, Constipation, Transcutaneous tibial nerve stimulation, Diaphragmatic breathing, Abdominal muscle training










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25 days from submission to first decision (Median)
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